A 6-week-old infant born prematurely at 30 weeks is now ready for immunization. The child's corrected age is 0 weeks (still in the NICU). Which vaccine should NOT be given at this time due to specific prematurity concerns?

• A Hepatitis B vaccine (if birth weight was ≥2 kg)
• B BCG — should be given only when weight is ≥2 kg
• C Pentavalent — safe at any gestational age by chronological age 6 weeks
• D OPV — should be delayed until discharge from NICU ✓

Explanation

OPV contains live attenuated poliovirus and is shed in stools. In NICU settings, OPV should be delayed until discharge to avoid shedding to other immunocompromised neonates. BCG can be given when weight ≥2 kg (or at discharge if <2 kg). Hepatitis B can be given at birth if ≥2 kg or at 1 month if <2 kg. Pentavalent (DPT+HepB+Hib) and IPV are given by CHRONOLOGICAL age (not corrected age) starting at 6 weeks regardless of gestational age, with IPV preferred over OPV for NICU infants. Thus OPV specifically is delayed in the NICU.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.